Provider Demographics
NPI:1740971084
Name:KEITH, THOMAS BRYANT (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:BRYANT
Last Name:KEITH
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
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Other - First Name:
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Mailing Address - Street 1:1035 W FORT WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:SYLACAUGA
Mailing Address - State:AL
Mailing Address - Zip Code:35150-2301
Mailing Address - Country:US
Mailing Address - Phone:256-249-4701
Mailing Address - Fax:888-897-9658
Practice Address - Street 1:1035 W FORT WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-2301
Practice Address - Country:US
Practice Address - Phone:256-249-4701
Practice Address - Fax:888-897-9658
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ALPTH11350225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist